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目的:探讨纤维支气管镜、胸部CT诊断侵袭性肺曲霉病的价值。方法:回顾性分析26例经病理确诊侵袭性肺曲霉病患者的纤维支气管镜、胸部CT影像资料。结果:26例胸部CT检查均未见肺曲菌球等特征性表现;纤维支气管镜检查6例未见明显异常,镜下见结石样或结晶样异物阻塞管口或突向管腔5例,类似肿瘤样新生物阻塞受累管腔2例,受累支气管壁呈非特异性炎症改变3例,菜花样或肉瘤样新生物堵塞或突出管腔10例。结论:侵袭性肺曲霉病胸部CT诊断敏感性差,纤维支气管镜检查刷片及活检可提高确诊率。
Objective: To investigate the value of fiberoptic bronchoscopy and chest CT in the diagnosis of invasive pulmonary aspergillosis. Methods: A retrospective analysis of 26 cases of pathologically confirmed invasive pulmonary aspergillosis patients with bronchoscopy, chest CT image data. Results: No characteristic manifestations such as pulmonary aspergillosis were found in 26 cases of chest CT. No obvious abnormalities were observed in 6 cases of bronchoscopy, 5 cases of obstruction of mouth or protruding lumen were seen in the microscope, A tumor-like neoplasm occluded the affected lumen in 2 cases, the affected bronchial wall showed a nonspecific inflammatory change in 3 cases, cauliflower-like or sarcomatous-like neoplasms blocked or highlighted the lumen in 10 cases. Conclusion: The CT diagnosis of invasive pulmonary aspergillosis is not sensitive to chest CT scan and biopsy can improve the diagnosis rate.